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Results In North Carolina Baptist Hospital clinic attendees, a given glycated haemoglobin was associated with higher serum glucose concentrations in African-Americans compared with whites. In a multivariate model with glycated haemoglobin as the outcome variable, racial differences remained significant after adjustment for serum glucose, age, gender and kidney function. For individuals with a serum glucose between 5.6 and 8.3 mmol/l, the glucose : glycated haemoglobin ratio was 1.03 ± 0.16 mmol/l/% in white individuals and 0.99 ± 0.17 mmol/l/% in African-Americans (P < 0.0001). For a glycated haemoglobin value of 7.0%, there was a 0.98-mmol/l difference in predicted serum glucose concentration in 50-year-old African-American men, relative to white. Results were replicated in the DHS, where in a best-fit linear model, after adjustment for glucose, African-American race was a significant predictor of glycated haemoglobin (P < 0.0001).

Conclusions African-Americans have higher glycated haemoglobin values at given serum glucose concentrations relative to whites. This finding may contribute to the observed difference in glycated haemoglobin values reported between these race groups.

Aims To determine the effect of sickle cell trait on measurement of glycated haemoglobin (HbA1c) in African American patients with diabetes mellitus.

Methods This is a retrospective study including 885 outpatients who underwent HbA1c testing. Medical record review and sickle cell trait determinations based on the HbA1c assay were performed in African American participants. The relationship between HbA1c and serum glucose measurements was analysed.

Results Data were obtained from 385 AA (109 with SCT, 22 with haemoglobin C trait and 254 without haemoglobinopathy) and 500 European American patients. In a model created through multivariate repeated-effects regression, the relationship between HbA1c and simultaneous serum glucose did not differ between African American subjects with and without the sickle cell trait, but differed between African American subjects without the sickle cell trait and European Americans (P = 0.0002).

Conclusions Sickle cell trait does not impact the relationship between HbA1c and serum glucose concentration. In addition, it does not appear to account for ethnic difference in this relationship between African Americans and whites.